Does job-based or Marketplace insurance cover mammogram?

A screening mammogram is usually covered at $0 in network for women 40 and older. Preventive guidelines recommend screening mammograms every 1–2 years starting at age 40. Diagnostic mammograms (for a lump, symptoms, or follow-up) are covered but usually involve your deductible or coinsurance. Cost: $0 in network when it qualifies as preventive; follow-up or diagnostic work can have normal cost sharing.

Does Original Medicare cover mammogram?

Yes, Medicare covers a screening mammogram every 12 months at $0. Part B covers yearly screening mammograms for women 40 and older and one baseline between 35 and 39. Diagnostic mammograms are covered with the Part B deductible and 20% coinsurance. Cost: Screening $0 with an assigning provider; diagnostic is generally 20% after the deductible.

Does Medicare Advantage cover mammogram?

Yes, Medicare covers a screening mammogram every 12 months at $0. Part B covers yearly screening mammograms for women 40 and older and one baseline between 35 and 39. Diagnostic mammograms are covered with the Part B deductible and 20% coinsurance. Medicare Advantage plans must cover Medicare’s preventive services at $0 when you use an in-network provider. Cost: $0 in network for the preventive service; follow-up care can have your plan’s copays.

Does Medicaid cover mammogram?

Yes, Medicaid covers screening and diagnostic mammograms. State programs cover breast cancer screening; cost sharing is $0 or minimal.

Is mammogram covered by insurance?

Breast cancer screening or diagnostic breast imaging. Here’s how each kind of plan usually handles it.

Ask a specific question Plan a visit: cost and doctors Check it against my plan

Employer or MarketplaceUsually covered
A screening mammogram is usually covered at $0 in network for women 40 and older.
More details
Preventive guidelines recommend screening mammograms every 1–2 years starting at age 40. Diagnostic mammograms (for a lump, symptoms, or follow-up) are covered but usually involve your or .
Cost: $0 in network when it qualifies as preventive; follow-up or diagnostic work can have normal cost sharing.
Original MedicareUsually covered
Yes, Medicare covers a screening mammogram every 12 months at $0.
More details
covers yearly screening mammograms for women 40 and older and one baseline between 35 and 39. Diagnostic mammograms are covered with the Part B and 20% coinsurance.
Cost: Screening $0 with an assigning provider; diagnostic is generally 20% after the deductible.
Medicare AdvantageUsually covered
Yes, Medicare covers a screening mammogram every 12 months at $0.
More details
covers yearly screening mammograms for women 40 and older and one baseline between 35 and 39. Diagnostic mammograms are covered with the Part B and 20% coinsurance. Medicare Advantage plans must cover Medicare’s preventive services at $0 when you use an in-network provider.
Cost: $0 in network for the preventive service; follow-up care can have your plan’s copays.
MedicaidUsually covered
Yes, Medicaid covers screening and diagnostic mammograms.
More details
State programs cover breast cancer screening; cost sharing is $0 or minimal.

Plan type	How it’s usually covered
Employer or MarketplaceUsually covered	A screening mammogram is usually covered at $0 in network for women 40 and older. Preventive guidelines recommend screening mammograms every 1–2 years starting at age 40. Diagnostic mammograms (for a lump, symptoms, or follow-up) are covered but usually involve your or . Cost: $0 in network when it qualifies as preventive; follow-up or diagnostic work can have normal cost sharing.
Original MedicareUsually covered	Yes, Medicare covers a screening mammogram every 12 months at $0. covers yearly screening mammograms for women 40 and older and one baseline between 35 and 39. Diagnostic mammograms are covered with the Part B and 20% coinsurance. Cost: Screening $0 with an assigning provider; diagnostic is generally 20% after the deductible.
Medicare AdvantageUsually covered	Yes, Medicare covers a screening mammogram every 12 months at $0. covers yearly screening mammograms for women 40 and older and one baseline between 35 and 39. Diagnostic mammograms are covered with the Part B and 20% coinsurance. Medicare Advantage plans must cover Medicare’s preventive services at $0 when you use an in-network provider. Cost: $0 in network for the preventive service; follow-up care can have your plan’s copays.
MedicaidUsually covered	Yes, Medicaid covers screening and diagnostic mammograms. State programs cover breast cancer screening; cost sharing is $0 or minimal.

What usually has to be true

Your age and how often you’re screened decide whether it’s $0.
Diagnostic mammograms and follow-up ultrasounds can have cost sharing.
Some plans or states cover 3D mammography or breast ultrasound at $0; others charge extra.

Good to know

A screening can become diagnostic if a problem is found.
Many states require extra coverage for people with dense breast tissue.

Ultrasound · Sonogram imaging, including pregnancy ultrasounds.
Genetic testing · Hereditary risk, diagnostic, and tumor genetic tests.

Sources

Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.

1
Preventive care benefits for women
HealthCare.gov
Covered services for women include mammograms, cervical cancer screening, BRCA genetic counseling and testing for those at higher risk, bone density screening, contraception, well-woman visits, and breastfeeding support and supplies.
2
USPSTF A and B recommendations
U.S. Preventive Services Task Force
Services rated A or B by the Task Force, such as specified cancer screenings, PrEP for HIV prevention, and statin use for certain adults, generally must be covered without cost sharing by non-grandfathered plans.
3
Mammograms
Medicare.gov
Part B covers screening mammograms once every 12 months for women 40 and older at no cost when the provider accepts assignment; diagnostic mammograms are covered with the deductible and 20% coinsurance.
4
Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
5
Mandatory and optional Medicaid benefits
Medicaid.gov
States must cover mandatory benefits such as inpatient and outpatient hospital care, physician services, laboratory and X-ray services, home health, and nursing facility care; many other benefits, including adult dental, vision, and prescription drugs coverage details, are state options.

General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.

Is mammogram covered by insurance?

What usually has to be true

Good to know

Related

Sources